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Cutting refugee healthcare services is a government policy choice and opponents to the changes can express their dissent at the ballot, the Federal Court was told by a government lawyer Wednesday.

“The making and acting of policies are at the heart of the role of the government,” Marie-Louise Wcislo told a hearing Wednesday into the legality of the cuts to interim federal health (IFH) program. “We are all entitled to our personal views.”

Wcislo said the refugee health program is an insurance scheme and the government is only responsible for the funding. It’s up to individual doctors and hospitals to decide whether they’ll take on refugee patients Ottawa has declared ineligible.

On behalf of two patients affected by the cutbacks, groups representing lawyers and doctors for refugees have asked the court to declare the cuts made by the federal government last year unconstitutional and illegal, and order Ottawa to reinstate the health coverage for all refugees.

Wcislo said ineligible patients have at least seven options, including buying private health insurance, using stop-gap programs introduced by some provinces since the cuts, requesting free care from clinics for the medically uninsured, or crashing hospital emergencies.

“All of these are ways people can get access to healthcare,” Wcislo told Justice Anne L. Mactavish. “Provinces will grant access to provincial health care to those who are working legally in those provinces.”

Ontario recently joined four other provinces in defying the federal cuts and reinstating essential and urgent coverage as of Jan. 1, saying that among other things the cuts have led to unnecessary emergency room visits and stress on health providers. The province, home to 55 per cent of refugee claimants in Canada, has said it will send Ottawa the bill.

Under the old federal coverage, refugees at all stages of the asylum process were eligible for extended health services that included medications as well as vision, dental and medical care.

Under the new scheme, said Wcislo, 14 per cent of the population receives the same extended care, with 62 per cent on only basic health coverage and 24 per cent eligible for care if they pose a risk to public health.

“The IFH is a government program to ameliorate and help a group of people in the society. We could have a different government. There could be change again,” said Wcislo, adding that any public dissent should be dealt with in the political forum and not in court.

Lawyers for Canadian Doctors for Refugee Care and the Canadian Association of Refugee Lawyers argued earlier that the health cuts breached international law and the Charter of Rights by reducing and eliminating refugees’ access to health care.

Cutting off refugees from care previously available to them, and excluding only some based on their country of origin, for example, constitutes discrimination based on national and ethnic origin, they contended.

However, Wcislo said the designation is made based on refugees’ citizenship, which is not grounds for discrimination under the Charter. “The government could have repealed (the IFH) and done nothing more,” she said.

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